Sunday, February 28, 2016

February Blues

Ok, so it's been a little while. Happy New El Niño Year and all that stuff! I hope you are staying warm/cool, wet/dry, happy or whatever you need to be.

As we end the Worst Month of the Year (see last February's post), it's time to recap the most notable cases and events from this month.

The first day of February brought me a very sick dog who may or may not have eaten something very bad for him, a chicken carcass. Two days after the delectable treat disappeared, the dog ended up in our office flat out, barely moving. He had had two days of unproductive retching and straining to have a bowel movement. I bent down to lift up his lip to check his color, and his lip stayed in the up position. His abdomen was tense and painful and bloated. I finished my exam which left me feeling very worried about my patient. I informed the owner that the dog was severely dehydrated and may require surgery or at the very least would need to be hospitalized for several days.

"Well, I'm not going to spend a thousand dollars on this dog."

Um, ok. Guess it's gonna die then. I have news for you: one thousand dollars is not a lot of money. For something like, I don't know, a purse? Yeah, that's ridiculous. But not for a dog, especially a sick dog or a dog who will need emergency life saving surgery and care. No, not even two thousand is a lot of money for that. In fact, that would be a bargain.

Veterinary medicine is sophisticated, and we are surgically and medically up to par - and sometimes even more advanced - than our human counterparts. But just go ahead and compare the costs of veterinary care to the same services in human medicine. Its no contest: veterinary medicine is a bargain.

The minimum emergency diagnostics needed in this case of a potentially fatal condition including CBC, chemistry, abdominal X-rays, and abdominal ultrasound will come in at just under one thousand dollars. Surgery, IV catheter and fluids, pain control, hospitalization post op and other meds the pet may need would be another two, and that's assuming everything goes swimmingly.

Foreign body removal is something not routinely performed in human medicine, so it was difficult to find costs for a similar procedure, however cholecystectomy (gall bladder removal) is performed in both disciplines. Gall bladder removal costs for a dog total approximately $4,000. For this procedure in human medicine, the average cost is $76,000. 

Anyway, the owner elected euthanasia. That was the first of many I performed this month. Most were very old and sick animals who had had good lives (presumably) and were ready. There were a few incredibly sad cases that I can't even write about.

There was one good case that sticks out. It was a little terrier mix who we hadn't seen for an exam in awhile. The last exam was a year ago for blood in his urine. At the time, he had a negative culture, and I warned the owners about bladder stones. Apparently the blood resolved because we hadn't seen him again.

Fast forward to this week. He spent an entire day straining to urinate, was brought in after a referral by the emergency for urethral obstruction. This is a thing that happens to cats more often than dogs, and it is a life threatening emergency. We discussed the options.

"Occasionally when we discover bladder stones we can attempt to dissolve them using a special diet, but in this case, surgery is required. We can attempt to push the stone causing the obstruction back into the bladder, if we succeed we can perform a cystotomy to remove the stones, or if we can't we'll have to refer you to a surgeon. Or you can euthanize."

"No, I want to do the surgery." Ok, then! I was able to push the offending stone back into the bladder, then I removed over 50 stones from this poor dogs bladder, and by that afternoon he was peeing normally with almost no blood. Yay! Finally a happy ending.

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